Seven months ago, when Jake got out of jail in Phoenix, he expected to go back to using his drug of choice: heroin. But the street market for illegal opioids had changed.
“I just started smoking [fentanyl] pills because that was the thing that was around; it was so easy to get,” he said. NPR is only using Jake’s first name because he fears being arrested after talking openly about his addiction.
“Soon as I wake up, I have to have a pill,” Jake said. “The high is not very long, so 20 minutes after I smoke a pill, I want to smoke another one, you know?”
He lives on the street and occasionally sleeps in motels. He has been addicted to opioids — first heroin and now street fentanyl — for six years.
Several times a day, he crushes an illegally manufactured fentanyl pill on a piece of tin foil, then cooks the powder with a flame, sucking in the fumes.
Recently, Jake pushed his bike along a tree-lined street, heading to buy his next dose for $5 or $10 a pill.
“I can walk through the motel and have at least three or four people tell me they got pills for sale,” he said.
Much of the fentanyl reaching American street markets is still coming from mainland China, despite restrictions imposed by the Chinese government last year.
Working with new data collected by the Center for Advanced Defense Studies, an organization that receives funding from the U.S. government, NPR found Chinese companies have found ways to circumvent export bans.
Firms are marketing chemicals needed to make fentanyl on social media and working with drug cartels in Mexico.
Researchers also point to another devastating new development: Fentanyl is making swift inroads in the western U.S. where it used to be rare.
“It’s killing too many people”
“Up through 2018, the vast majority of synthetic opioid overdoses occurred east of the Mississippi River,” said Chelsea Shover, an epidemiologist at Stanford University.
People addicted to opioids in western states often use a different kind of heroin that doesn’t mix easily with fentanyl powder. But while studying overdose deaths last year, Shover and other researchers found what they describe as a “fentanyl breakthrough” in the West.
The data showed fentanyl had begun killing far more people in cities such as Los Angeles, Seattle and Phoenix, including people with addiction who didn’t know their drugs were contaminated.
“You think you’re using heroin or you think you’re using Ecstacy or Xanax or what looks like an Oxycontin pill, but it’s actually fentanyl,” Shover said.
The spike in fentanyl deaths in the West contributed to a record number of fatal overdoses last year, with roughly 72,000 Americans dead.
“It’s just getting worse, and it’s killing too many people,” said Matthew Donahue, deputy chief of operations for the Drug Enforcement Administration.
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